Do You Agree With My Choice For 800cc High Profile Under Muscle Saline Implants?(photo)

So surgery is a week away and I just wanted a second opinion. Ps and I agreed on 800cc HP under the muscle Saline. I really don't want upper pole fullness so should I change anything at prep (tomorrow!) OR does our plan sound good! Also does it look like I have enough tissue to get good results with saline? Thanks for any advice in advance :) 5'6 150 lbs BWD: 14

Doctor Answers 22

800 cc implants will create upper pole fullness

Based on your photo and the measurements provided, 800 cc implants will certainly create upper pole fullness.

It does not appear that you have enough tissue coverage to get a good result with saline implants that are this large.

800 cc Saline Implants

You asked for our opinion and it looks like you got it. I think I'd lean more towards 900cc TOTAL. That means 450 per side.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 20 reviews

You may be making a huge mistake.

Thank you for including photos, and the comment that you "don't want upper pole fullness." I'm not sure what "prep" is, but you should take the suggestion that others have given and wear 800cc implants in your bra for a few hours and see what that looks and feels like. How did you and your PS arrive at 800cc?

800cc is over 3 cup sizes larger than what you have now, and even though you have some breast droop, your nipples are above your inframammary crease, and augmentation alone is all that is needed to give you a good result. However, adding over 3 cup sizes into your skin brassiere will undoubtedly give you a high, tight, rounded look that certainly adds upper pole fullness--that volume has to go somewhere. It may also give you an inframammary double bubble deformity as your implant causes a "new" lower inframammary crease below your natural one.

Furthermore, you should be considering silicone for the softest, most natural feel and to avoid the possibility for requiring re-operation if your saline implant(s) leak and deflate, which cannot happen with the latest generation of cohesive silicone gel implants. Below the muscle will help to keep the upper pole fullness down compared to above the muscle, and below the muscle also has the lowest likelihood of bacterial contamination (from intraductal bacteria) that can lead to capsular contracture (which will give you HARD, high, tight upper pole fullness).

Truly, I am usually the plastic surgeon on this site who champions patient choice--in coordination with the surgeon's assessment of your anatomy--regarding implant size, and I do use 800cc implants on occasion. I just really question your surgeon's judgement and experience if he/she condones, agrees, or promotes this choice for your anatomy. Have you shown your surgeon photos of patients or nude models with the breast size and appearance you desire?

Reschedule surgery and get another or two consultations and see if 800cc is offered by experienced, ABPS-certified plastic surgeons with lots of breast experience. If you can get one or more PS to agree with this plan, then you can always go ahead. But if not, you should realize there IS a reason that virtually all of your on-line experts are in agreement that this will be a huge mistake, and one that perhaps cannot be undone by simply "exchanging for smaller implants." You can always go bigger, but going smaller is much more problematic.

Good luck and best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 207 reviews

Breast Implants too Big

Hello again Itskasey,

Wow.  You really don't get it.  Read the other doctor's posts, I'm not just one lone opinion that doesn't match the other doctor's opinions (except of course the doctor you're choosing).  We are all telling you this is a bad idea.

Based on your photograph you have provided, and what you've said about not wanting upper pole fulness, you will not be happy with your choice of 800 cc HP.  HP is all about more pronounced upper pole fullness, and an 800 cc implant has no where to go on you but up.  Looking at your photograph, your nipple to inframammary fold distance appears relatively short, which means he will have to significantly lower your fold to properly position this large implant under the breast mound, and to keep your nipples from pointing south.  Pinch your skin just under your breast; that will be all that is covering the bottom of the implant afterward.

One other thing to consider is that this will not be a reversable event in case you think you'll just go for it, and if you don't like it, you'll just 'change them out for another pair'.  This will cause irreversable and possibly uncorrectable problems for you.  This is really serious!

As the others have told you, nows a time to be thoughtful, not rash.

I hope you reconsider.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 54 reviews

Implant Selection Process

I would caution against an implant of this size.  It will most definitely lead to implant complications.  Generally speaking,larger implants increase the risk of complications such as implant malposition, which can be very difficult to correct longterm.  In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 70 reviews

Very Large Implants

800ccs is a very large implant for a primary augmentation!  You state that you don’t want upper pole fullness, but this implant will likely give you a very unnatural result.  Have a discussion with your surgeon sooner rather than later regarding your surgical goals.

Large Breast Implant Augmentation

I am not sure how the size of 800cc was selected for your body frame and breast base width. Besides being way too big for base width, implants of that size will give you a very round breast appearance and a lot of upper pole fullness...exactly what you say you don't want. It is more likely that the right size wwould be closer to 800cc total for both breasts combined or 400cc to 450cc per side.

800cc breast implants too large?

The larger you go, the greater percentage of your final breast volume will be implant, and the more your breasts will look, behave, and feel like the implants.  Because the texture of silicone gel, due to its viscosity, is more natural than saline, the larger you go, the more advantageous gel implants become.  My recommended max for you is 600-650 ml, depending on chest width, and at that size, gel is preferred over saline.  Large saline implants also more prone to rippling and wrinkling.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 44 reviews

Large high profile implants may not be your best choice

High profile saline filled implants will definitely yield a very round breast with superior breast fullness.   The upper pole will be more shelf like as opposed to a moderate plus profile.  In addition, an 800 cc implant weighs almost 2 pounds.  It is important to remember that time weight and gravity are not on your side.   While it is possible to make breasts very large it does have consequences and some of these may not be desirable.  As a plastic surgeon I try to take patients from what is possible to understanding their own tissue dynamics and the effects of implants over time.  It would be best to fully discuss your options.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 14 reviews

You should not get 800 cc implants

There are limitations to the implant size. Your breast tissue can not and will not handle 800 cc implant. You will have thinning of the skin and breast tissue and implant shifting to the axilla. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 95 reviews

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